输卵管妊娠经阴道彩色多普勒超声表现与保守治疗疗效关系的探讨

Relation between transvaginai color Doppler sonographic findings and the medical conservative treatment results of tubal pregnancy

目的探讨经阴道彩色多普勒超声（TVCD）在化学药物治疗早期输卵管妊娠（TP）中的应用价值。方法临床确诊并接受化学药物保守治疗的TP患者50例，在用药的前一天，应用TVCD测量“输卵管环征”包块的大小，对其血供状况进行Adler分级，并测定相应的血流参数；将超声表现与临床治疗结果进行对比分析。结果50例中45例保守治疗成功，5例失败，治疗成功率90％（45／50）。成功组中，TP包块血流信号0级4例，Ⅰ级21例，Ⅱ级16例，Ⅲ级4例，其中41例测及血流，Vmean（5．452±4．327）cm／s，PI1．597±0．696，R10．680±0．107；失败的5例包块血流均为Ⅲ级，Vmean（16．774±9．855）cm／s，P10．951±0．193，R10．567±0．034。结论“输卵管环征”包块的TVCD表现与TP保守治疗的疗效有一定关系，对预测早期TP保守治疗的疗效具有重要意义。

Objective To evaluate the value of transvaginal color Doppler sonography（TVCD） in the conservative treatment of early tubal pregnancy（TP）. Methods Fifty cases of early TP were examined by TVCD before medical treatment, including the size of TP mass, blood flows graded according to Alder, hemodynamics parameters. All data were ananlized and compared with therapeutic results. Results Forty five cases were treated successfully （45/50） ,and 5 failed. According to TVCD,TP masses flow were graded from 0 to Ⅲ. In the successful group,4 cases were graded 0,21 Ⅰ ,16 Ⅱ and 4 Ⅲ ,blood flow signals were measured in 41 cases, the mean velocity was （5. 452 ± 4. 327）cm/s,PI （1. 597 ± 0. 696）,RI 0. 680 ± 0. 107. In the failure group,all TP masses flow were graded Ⅲ ,the mean velocity was （16. 774 ±9. 855）cm/s,PI 0. 951 ± 0. 193, RI 0. 567 ± 0. 034. Conclusions In the medical treatment of early TP, TVCD findings associated with the treatment outcome closely, it plays an important role in assessing conservative treatment of early TP.